Allowing Certified Professional Midwives (CPMs) to practice to their full scope, including the ability to obtain, carry, and administer medications and operate under standing orders from a prescribing provider, is essential to ensuring safe, efficient, and equitable maternity care. Access to medications such as anti-hemorrhagics, IV fluids, antibiotics, and local anesthetics enables CPMs to respond swiftly to common and urgent complications, reducing the need for unnecessary transfers and improving continuity of care. Additionally, standing orders provide a structured, supervised framework that expands the CPM’s ability to manage care within evidence-based protocols, ensuring timely and appropriate intervention when necessary. This approach not only enhances patient safety and autonomy but also supports collaborative care models, strengthening integration with the broader healthcare system while maintaining the midwifery model of care. Expanding CPMs' scope in this way improves access to essential services, particularly for those in rural and underserved areas, where midwives often serve as the primary maternity care providers.

Special Thanks

Special thank you to Kristin Effland, CPM, MA-MCHS, and Britney Zell, LM, CPM, MSM, for all their hard work putting the first spreadsheet together, sharing it with us, and allowing us to host the information and keep it up to date.

Sources

Effland, K. J., Hays, K., Zell, B. A., Lawal, T., & Koontz, M.. (2021). Medication access & midwifery integration: An Example of community midwifery advocacy for access in Washington state, USA. Birth: Issues in Perinatal Care, 48(1), 4-13. http://dx.doi.org/10.1111/birt.12523 

Effland, K. J., Hays, K., Zell, B. A., Lawal, T., Grantham, R. L., & Koontz, M. (2021). Increasing Access to Medications and Devices for the Care of Low-Risk Childbearing Families: An Analysis of Existing Law and Strategies for Advocacy. Journal of Midwifery & Women’s Health. 66(5), 604-623. https://doi.org/10.1111/jmwh.13275

Maternal Health Program - Midwifery Licensing. "PLEASE READ: Updated DOH Practice Guidelines for NM Licensed Midwives Have Been Posted and Are in Effect." Received by [Your Name], 26 Feb. 2025. Email.

More information

Zell, B., Effland, K., Hays, K., Snyder, M., Gordon, W. (2024). Prescriptive Authority for Direct Entry Midwives in Washington State: Increasing Client Access to Contraception. Journal of Midwifery & Women’s Health. 69(4), 600-605.  https://onlinelibrary.wiley.com/share/author/ZDPX4YNYDAKJAJRJVPW9?target=10.1111/jmwh.13606 or http://doi.org/10.1111/jmwh.13606

For insights or corrections to the information listed, please contact Zev@nacpm.org. When submitting updates, kindly include relevant sources to ensure accuracy and reliability.